Emergency Procedure Applied to Tackle the Lack of Sphericity after Cutting the Bone Bed for Cementless Hip Arthroplasty - The Acetabular Screw-Cup System Developed by Aesculap

BACKGROUND The study aimed to analyze the complications following cementless arthroplasty surgery where original sphericity was not obtained and screw-cap system was required. METHOD The study inclusion criteria were met by 39 patients aged 47 - 90 and the mean follow-up period was 54 months. Patients were operated in a lateral position, through the posterolateral or minimal posterior approach.To assess postoperative functionality, Harris Hip Score and Hoos questionnaire were applied. RESULTS According to the Harris Hip Score, 64.3% of the scores were very good and good and the mean score was 96 according to the Hoos questionnaire. The incision type, BMI and the type of cutaneous suture had no impact on the functional outcome, incidence of complications and a pain rate in the groin. Scar esthetics received highest scores from the patients operated through the minimal posterior approach and treated with a running intra-cutaneous suture. Yet a lateral position during the surgery made any intraoperative assessment of the limb length considerably more difficult. Consequently, 30% of the operated patients reported different limb lengths, which significantly (p = 0.036) lowered a functional outcome measured according to the HOOS and Harris Hip Score. The functional outcomes demonstrate a considerably negative correlation with age but not with gender although men are more vulnerable to the postoperative complications (p = 0.18). CONCLUSION Despite a relatively large number of complications following the surgery using a screw-cap system, 75% of the patients declared they would not mind another surgery using such system.